Mesenchymal Chondrosarcoma of the Brain with Metastasis: A Case Report with Literature Review

Bhardwaj, Sandeep; Sharma, Ashish; Sharma, Akangsha

doi:10.1055/s-0040-1709355

Cited by 5 publications

(4 citation statements)

References 10 publications

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“…The list of our own and published lesions appears in Table 2. 2–99 Published cases of 4 of the listed diagnoses were not reviewed because there is a significant literature on these already (sickle cell crisis with sphenoid infarction, tuberculosis of orbital bone, sphenoid bone dysplasia in NF1, and fibrous dysplasia of bone). During the same period as these new cases were collected from our practices, 97 cases (21 males) of spheno-orbital meningioma were encountered by us.…”

Section: Resultsmentioning

confidence: 99%

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Spheno-orbital Lesions—A Major Review of Nonmeningioma Causes

McNab

Jones

Hardy

2021

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose: To review the imaging features of the broad range of nonmeningioma lesions of the greater wing of the sphenoid (GWS) bone and adjacent orbit to assist clinicians in differentiating these lesions from each other and from the most common lesion of the GWS and adjacent orbit, meningioma. Methods: We reviewed 32 cases of spheno-orbital lesions involving the GWS from our own practice, as well as 109 published cases (total 141), with emphasis on available imaging features on computerized tomography (CT) and MRI. Features that might assist in differentiating meningioma from its mimics were analyzed for each lesion, including the presence of an osteoblastic or hyperostotic response, bone erosion or osteolysis, homogeneous hypo- or hyperintensity on T2-weighted MRI, leptomeningeal involvement, and the absence of a “dural tail” on contrast-enhanced MRI. The clinical and imaging features were also briefly summarized for each diagnostic group. Results: The largest diagnostic group was metastasis (67 cases, 47.5%). The most useful imaging features that helped differentiate meningioma from its mimics were the presence of bone erosion and the absence of a “dural tail.” Other features were helpful in a small minority of cases only. Metastatic prostate cancer was the largest single group (21 cases), and 18 (85.7%) of these were osteoblastic and most closely mimicked meningioma. Prostate cancer patients were generally older than males with GWS meningioma. Almost all other (44/46, or 95.7%) metastatic lesions showed evidence of bone erosion. Almost half (30 of 61, 49.2%) of patients with metastasis presented without a known diagnosis of malignancy. Among children 16 years of age and less, Langerhans cell histiocytosis (10 cases), dermoid cyst (5), and Ewing’s sarcoma (5) were the most common diagnoses. Conclusions: A combination of a careful history and both CT and MRI gives information, which can best guide the management of patients with spheno-orbital lesions. Metastatic prostate cancer to the GWS most closely mimics GWS meningioma but can in most cases be differentiated on clinical and imaging features. Older males with hyperostotic lesions of the GWS should be investigated for prostate cancer. Other metastatic lesions and primary tumors of the GWS, as well as benign and structural lesions can readily be differentiated from meningioma on clinical and imaging features.

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Section: Resultsmentioning

confidence: 99%

“…We identified 2 cases involving the GWS. 25,26 Calcification within the mass is common, and microscopically new bone formation occurs, but this is not in a pattern of hyperostosis of the GWS, which is eroded, but within the soft tissue component of the lesion.…”

Section: Infectionmentioning

confidence: 99%

Spheno-orbital Lesions—A Major Review of Nonmeningioma Causes

McNab

Jones

Hardy

2021

Ophthalmic Plastic &Amp; Reconstructive Surgery

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“…Clinically these tumors present with symptoms caused by increased intracranial pressure or the compression of adjacent neurological structures. Frequent symptoms include a progressive history of headache, third cranial nerve palsy, and decreased vision [12]. Due to the low incidence, the mesenchymal chondrosarcoma is often studied together with the classical chondrosarcoma.…”

Section: Discussionmentioning

confidence: 99%

Hypofractionated Gamma Knife Stereotactic Radiosurgery as a Tool for Intracranial Mesenchymal Chondrosarcoma Local Treatment: Case Report and Literature Review

Jakstas¹,

Tamašauskas

Radžiūnas

et al. 2021

BJSTR

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Background: Mesenchymal chondrosarcoma is a rare, aggressive cartilaginous forming tumor rarely encountered in neurosurgical practice. Due to low incidence and lack of study of this disease, treatment options remain controversial, and due to its aggressive nature and high probability of metastasis, prognosis remains poor. Case Description: A 3.5-year-old male patient diagnosed with extraosseous mesenchymal chondrosarcoma, which was first located in the lumbar spine, treatment started with subtotal tumor resection, local radiotherapy, and chemotherapy. PET and MRI did not show metastasis or recurrent tumors for 1.5 years. Then tumor metastasized infratentorialy. This lesion was treated with surgery and chemotherapy. However, the recurrence was detected a few months later in the region of the cerebellum. The patient underwent subtotal tumor removal. Due to the patient's young age, big treatment volume, and tumor remnant proximity to the brain stem, hypofractionated stereotactic radiosurgery was chosen. Leksell Gamma Knife Icon was used to deliver 5 stereotactic radiosurgery fractions. Local control was achieved for 9 months. Later MRI showed progression and new metastasis along the spinal canal. To our knowledge, it is the first publication presenting hypofractionated stereotactic radiosurgery with Gamma knife after extraskeletal mesenchymal chondrosarcoma neurosurgical resection. Conclusion:Surgical resection should be the cornerstone for treating this disease, followed by adjuvant treatment modalities -radiotherapy and chemotherapy. Hypofractionated radiosurgery with the Gamma knife can achieve local control near critical brain structures. However, due to high metastatic potential, conventional craniospinal irradiation should be considered as the first line treatment option after the first tumor recurrence.

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“…The expression of particular markers can also help differentiate the mesenchymal and other subtypes of CS. MCS stains positive for S-100 and SOX9, like CCS [ 27 ]; however, it tends to be CD99, ezrin, and NKX2.2 positive, in contrast to CCS [ 28 , 29 ]. On the other hand, similarly to other subtypes of CS, MCS may demonstrate p53 overexpression [ 30 ].…”

Section: Chondrosarcoma Diagnosticsmentioning

confidence: 99%

Mesenchymal Chondrosarcoma from Diagnosis to Clinical Trials

Dudzisz-Śledź,

Kondracka,

Rudzińska

et al. 2023

Cancers

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Mesenchymal chondrosarcoma (MCS) is a rare subtype of chondrosarcoma with a poor prognosis. Although these tumors are sensitive to radiotherapy/chemotherapy, the standard treatment for localized MCS is only surgical resection, and there are no established treatment guidelines for patients with advanced and metastatic MCS. Due to the low incidence of MCS, the pathology of these tumors is still unknown, and other therapeutic options are lacking. Some studies show the potential role of the PDGF/PPI3K/AKT, PKC/RAF/MEK/ERK, and pRB pathways, and BCL2 overexpression in the pathogenesis of MCS. These findings provide an opportunity to use protein kinases and BCL2 inhibitors as potential therapy in MCS. In this review, we summarize the current knowledge about MCS diagnosis and treatment options. We show the immunological and molecular biomarkers used in the diagnosis of MCS. In addition, we discuss the known prognostic and predictive factors in MCS. Finally, we present the novel trends, including targeted therapies and ongoing clinical trials using protein kinase inhibitors and the death receptor 5 (DR5) agonist, which may be the focus of future MCS treatment studies.

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Mesenchymal Chondrosarcoma of the Brain with Metastasis: A Case Report with Literature Review

Cited by 5 publications

References 10 publications

Spheno-orbital Lesions—A Major Review of Nonmeningioma Causes

Spheno-orbital Lesions—A Major Review of Nonmeningioma Causes

Hypofractionated Gamma Knife Stereotactic Radiosurgery as a Tool for Intracranial Mesenchymal Chondrosarcoma Local Treatment: Case Report and Literature Review

Mesenchymal Chondrosarcoma from Diagnosis to Clinical Trials

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